Foot and ankle arthritis can be very painful and can limit your mobility. Eventually, it can even deform your foot or ankle as the joints wear down and the bones begin rubbing against one another and wearing each other down.
Foot or ankle arthritis can be treated with pain management, specialized braces or shoe inserts, or even surgery. The first step is to diagnose the possible arthritis and determine the cause. It may be caused by a lifestyle issue, such as being on your feet too long each day or jogging in shoes that don’t protect your foot from impacts properly. The cause could be as the result of an infection or an inflammatory disease, such as rheumatoid arthritis.
The ankle is made up of the base of the tibia (shin bone), fibula (other leg bone) and talus (ankle bone). The foot has 30 bones, including the tarsals (upper foot), metatarsals (middle foot), and phalanges (toes).
The joints of these bones are covered in a thin layer of tissue called the synovium, which protects the bones from friction from the muscles, tendons, and ligaments. The bones are separated by cartilage.
Wear and tear over time can wear down the cartilage, inflame the synovium or ligaments, or deteriorate the bones. This can lead to various forms of arthritis, with osteoarthritis being one of the most common types. The foot and ankle can also be affected by inflammatory arthritis, such as rheumatoid arthritis.
The most obvious sign of arthritis in the foot or ankle is pain, but it’s when and how the pain occurs that helps us determine what type of arthritis and how best to treat it. The first step is to diagnose arthritis, and the most common way to do that is with x-rays or a CT scan.
We will also examine how and when the pain is the most severe. Is it during the early morning or late in the evening? Does it flare up with more activity, or when pressure is applied to the joints? Does the joint swell or become red? Does walking become more difficult as the day wears on?
Once we determine whether you have arthritis and the type of arthritis, we can create a treatment plan that is right for you.
Treatment of your foot or ankle arthritis depends on the type, the severity, and the amount of damage to the joint.
In many cases, arthritis can be treated without surgery. Instead, we create a treatment plan that includes changes in lifestyle, a regimen of medication, braces or other support devices, physical therapy, or a combination of those treatments.
Patients who jog may need to change to a lower-impact activity, such as cycling. Patients may need to wear an ankle or foot brace to stabilize the arthritic joint. Over-the-counter medication can be used to reduce inflammation and pain. These are a few of the possible treatment plans that can be implemented.
Surgery is another option. Early arthritis can be treated with arthroscopic surgery, which involves a small slit cut into the skin so a camera and surgical tool can be inserted for minimal invasiveness. The joint is cleaned up by removing excess bone or bone spurs, loose cartilage or the inflamed synovium.
In more severe cases, open surgery may be used to pin bones together so that they fuse. Reducing their movement will reduce arthritis pain.
Recovery from foot or ankle surgery can take several months because the injury needs to be fully healed before pressure or weight can be put on the foot. After the initial healing, the patient will likely undergo several weeks of physical therapy. Full recovery can take 4-9 months, depending on the complexity of the surgery and the rate of healing.